Cost Benefit Analysis of Improving Neonatal and Maternal Health Outcomes in Malawi

While notable progress has been made in Malawi’s efforts to meet the Millennium Development Goals surrounding child health and child survival, progress in curbing neonatal and maternal mortality and morbidity has been less substantial. Cost Benefit Analysis run against the most promising singular and sets of interventions within Malawi’s environment revealed two interventions with significant promise. Fisrtsly BEmONC5, a compacted set of five specific interventions taken from within the conventional basic emergency obstetric and newborn care package, would target key vulnerabilities facing maternal and neonatal health in Malawi, averting 3,900 still births, neonatal and maternal deaths in 2021, rising annually to 5,800 by 2035. Ensuring that 90% of hospitals and health centers have the necessary equipment, capacity, infrastructure, and medicines to deliver BEmONC5 would require approximately MWK 2.5 billion (USD 3.4m) every two years in investment, put toward staff, training, inventory expansion, medicines, equipment and electricity generators. Through this investment, Malawi would experience a 15% reduction in neonatal mortality, a 5%reduction in maternal mortality and a 13% reduction in stillbirths, enjoying 31 kwacha in social benefits for every 1 kwacha invested. Secondly replacing the existing iron and folic acid (IFA) supplements with multiple micronutrients (MMN)1 for pregnant women would lead to 1300 to 1600 averted stillbirths and neonatal deaths per year. Scaled up to full coverage across Malawi, this program would require an investment of MWK 1.5 – 2.5 billion (USD 2.0m – 3.4m) annually over the next 10 years. Additional interventions considered in the main analysis include the conventional 15-intervention package of basic emergency obstetric and newborn care (BEmONC) interventions and calcium supplementation in pregnancy. However, these are not as effective uses of resources and would represent less cost-effective uses of limited resources than the above interventions. Further analysis regarding these interventions can be found in the more detailed technical report.